Esthetics and Vertical Tooth Position: Orthodontic Possibilities
You will receive 1 credit(s) of continuing education credit upon successful completion of this course. The purchase price of this course is $49.00


This course presents five case study situations in which pre-restorative orthodontics contributed great benefit to restorative esthetics.

Vincent G. Kokich, DDS

Learning Objectives:

Upon completion of this course, participants should be able to do the following

  1. Determine which restorative situations can benefit from vertical orthodontic repositioning.
  2. Describe treatment options for correcting a "gummy smile."
  3. Explain the importance of allowing sufficient time for the teeth to stabilize after completion of the intrusion/extrusion process.
  4. Identify the appropriate treatment for correcting discrepancies in gingival levels.


Throughout the 1990s, esthetic dentistry became a prominent part of the treatment protocol of most dentists. Patients have become more conscious of the benefits of a beautiful smile and are willing to invest time and money to improve the appearance of their teeth. Many of these patients can be treated with routine restorative procedures (crowns, composites, laminates) to achieve the desired results. However, some patients have problems with tooth position creating significant discrepancies in gingival levels, which can compromise the esthetic result of restorative dentistry. Pre-restorative orthodontic therapy can often resolve these tooth position problems and enhance the esthetic restoration. This course describes the indications, methods, and results achieved when orthodontics preceded restorative dentistry in the treatment of various esthetic challenges.

  1. Introduction
  2. Case Studies:
    1. Case 1 - Irregular Appearance of Anterior Maxillary
    2. Case 2 - Gummy Smile
    3. Case 3 - Missing Maxillary Laterals
    4. Case 4 - Eroded Central and Lateral Incisors
    5. Case 5 - Short Maxillary Incisors

  3. Summary


  1. Kokich V, Nappen D, Shapiro P. Gingival contour and clinical crown length: their effects on the esthetic appearance of maxillary anterior teeth. Am J Orthod. 1984; 86:89-94.
  2. Kokich V. Enhancing restorative, esthetic, and periodontal results with orthodontic therapy. In: Schluger S, Yuodelis R, Page R, et al, eds. Periodontal Therapy. Philadelphia, PA: Lea and Feiberger; 1990: 433-460.
  3. Kokich V. Anterior dental esthetics: an orthodontic perspective, Part 1: Crown length. J Esthet Dent. 1993; 5:19-23.
  4. Kokich V: Anterior dental esthetics: an orthodontic perspective, Part 2: Vertical relationships. J Esthet Dent. 1993; 5:174-178.
  5. Chiche G, Kokich V, Caudill R. Diagnosis and treatment planning of esthetic problems. In: Pinault A, Chiche G, eds. Esthetics in Fixed Prosthodontics. Chicago, IL: Quintessence Publishing Co Inc; 1994: 33-52.
  6. Dellinger E. A histologic and cephalometric investigation of premolar intrusion in the Macaca speciosa monkey. Am J Orthod. 1967; 53:325-355.
  7. Kokich V. Esthetics: the ortho-perio-restorative connection. Sem Orthod Dentofac Orthop. 1996; 2:21-30.
  8. Reitan K. Tissue rearrangement during retention of orthodontically rotated teeth. Angle Orthod. 1959; 29:105-113.
  9. Kokich V, Spear F. Guidelines for treating the orthodontic-restorative patient. Sem Orthod Dentofac Orthop. 1997; 3:3-20.

American Dental Association is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.